Simons Michiel, Ezendam Nicole, Bulten Johan, Nagtegaal Iris, Massuger Leon
*Department of Pathology, Radboud University Medical Center, Nijmegen; †Eindhoven Cancer Registry, Eindhoven; ‡Department of Medical Psychology, Tilburg University, Tilburg; and §Department of Obstetrics and Gynecology, Radboud University Medical Center, Nijmegen, the Netherlands.
Int J Gynecol Cancer. 2015 Sep;25(7):1208-15. doi: 10.1097/IGC.0000000000000473.
Patients with mucinous ovarian carcinoma (MOC) generally have a favorable prognosis, although in advanced stage, prognosis is significantly worse compared to patients with serous ovarian carcinomas (SOCs). This might be due to the difficulties in distinguishing MOC from metastatic tumors. In the current study, we investigate prognosis of MOC compared to other types of ovarian cancer and to synchronous metastases to the ovary (sMO).
Age, laterality, International Federation of Gynecology and Obstetrics stage, tumor grade, treatment, and survival were extracted from the Eindhoven Cancer registry for all patients diagnosed with ovarian carcinomas or sMO between 1990 and 2012. Five-year survival analysis and Cox proportional hazards analysis were conducted.
A total of 3556 patients with primary ovarian carcinoma (of which 474 mucinous) and 289 with sMO were identified. In advanced stage, 5-year survival of patients with MOC was comparable to survival of patients with sMO (11% vs 11%, P = 0.32) and decreased compared to patients with SOC (26%, P < 0.01). For MOC, there was no clinically significant effect on 5-year survival of either debulking (12% vs 8%, P < 0.01) or chemotherapy (12% vs 10%, P = 0.02).
Patients with advanced stage MOC have a worse prognosis than advanced stage SOC. Survival is almost identical to that of patients with sMO. Effects of chemotherapy and debulking are limited in patients with MOC, which may be explained by suboptimal treatment due to the admixture of metastases in advanced stage MOC. Methods to differentiate between primary MOC and metastatic disease are needed to provide optimal treatment and insight in prognosis.
黏液性卵巢癌(MOC)患者通常预后良好,不过在晚期,与浆液性卵巢癌(SOC)患者相比,其预后要差得多。这可能是由于难以将MOC与转移性肿瘤区分开来。在本研究中,我们调查了MOC与其他类型卵巢癌以及卵巢同步转移癌(sMO)相比的预后情况。
从埃因霍温癌症登记处提取了1990年至2012年间所有诊断为卵巢癌或sMO的患者的年龄、患侧、国际妇产科联盟分期、肿瘤分级、治疗情况和生存情况。进行了五年生存分析和Cox比例风险分析。
共识别出3556例原发性卵巢癌患者(其中474例为黏液性)和289例sMO患者。在晚期,MOC患者的五年生存率与sMO患者相当(分别为11%和11%,P = 0.32),与SOC患者相比有所下降(26%,P < 0.01)。对于MOC,减瘤手术(分别为12%和8%,P < 0.01)或化疗(分别为12%和10%,P = 0.02)对五年生存率均无临床显著影响。
晚期MOC患者的预后比晚期SOC患者更差。生存率与sMO患者几乎相同。化疗和减瘤手术对MOC患者的疗效有限,这可能是由于晚期MOC中存在转移灶混合导致治疗效果欠佳。需要有方法来区分原发性MOC和转移性疾病,以便提供最佳治疗并深入了解预后情况。